What’s in a question? Responding to emotions
We say “respond to emotions” but what does this mean?
Emotions might sound like questions
And this can trip us up.
As clinicians we are trained to answer questions as fully as we can.
Because as clinicians we’re trained to answer questions. Years of exams, vivas, workplace-based assessments have primed us to think “Ahh that’s a question? I have an answer!” Then we delivery it as comprehensively as we can. Because, lets face it, explaining things is our comfort zone!
But sometimes (in fact often) questions contain emotion.
“Why hasn’t anyone updated me about my dad?”
“Don’t you read the notes?”
“What would it do if it was your mum facing this?”
“When are you going to let me go home?”
“Well of course I want everything what else were you thinking?”
“What are you going to do about…?”
“Why haven’t I seen the doctor for days?”
“…How long… how long have I got…?”
Whilst these questions need answers, they are also a window to the person’s deeper concerns.
And sometimes we give what we think is a factual answer and we don’t quite get it right, we may yet we receive more questions (or the same question repeatedly).
In those cases this might be a sign that something more is needed.
How might we respond?
You might simply use the “Heart-Head-Heart” model
Respond to the emotion
Give an answer based on your understanding of the facts
Give reassurance and empathy
Using the NURSE acronym we can think about how we respond to the emotion behind the question, particularly naming and understanding the core message. We might choose to use one response repeatedly until we have supported the person to process the emotion and be ready to move on to discussing more facts.
Use on or more of these microskills as a response to emotions, you may need to use them repeatedly to support your conversation partner.
We can also use other communication microskills such as
“Ask - Tell - Ask” to gather information and understand the deeper meaning.
“Sounds like this has been really bothering you?”
“I can give you an update about your father”
“Is there anything in particular you are worried about/you would like me to cover?”
In this way we provide support and make sure we are really answering the right question which might be
“Do you care about me?”
“Do you care about what I care about?”
“Can I trust you?”
How do we know a question might have an emotion attached?
There can be verbal and non-verbal cues. Typically if we don’t address emotions they tend to be expressed more, and we’ll notice this.
In my experience I feel - something - too. That self-awareness alerts me that there is more to do than simply provide facts.
Another sign is the factual answers don’t seem to provide reassurance.
Once we notice we are in a loop of providing more and more facts it may be that we are missing the emotion which also needs a response.
When I get it right
I hope the person feels somewhat seen and understood, and
I notice the conversation is able to move on.
Over to you
What alerts you to the need to respond to emotions?
What do you notice when you do this?
Think about this next time you answer a question and the response doesn’t seem to satisfy - what else might you try?
B. Ballane et al., "In-The-Loop": The Utilization of "Heart-Head-Heart" Communication in the Radiology Workplace. https://dx.doi.org/10.26044/ecr2023/C-10374
JW Childers, H Bulls, R Arnold. Beyond the NURSE Acronym: The Functions of Empathy in Serious Illness Conversations. J Pain Symptom Manage. 2023 Apr;65(4):e375-e379. DOI: 10.1016/j.jpainsymman.2022.11.029
